NUR104: Aged Care Workbook - Services, Risks, and Health

This assignment, completed for NUR104, addresses several critical aspects of aged care in Australia. It begins by discussing the advantages and challenges of older people remaining in their own homes, considering factors such as family care, cost-effectiveness, and potential burdens on caregivers. The assignment then explores the My Aged Care website, outlining how older individuals can access information and services. It identifies an organization, the Council on the Ageing (ACT), and explains its role in supporting and protecting older Australians. The assignment also examines the benefits of meaningful leisure activities, such as the men's shed, on the physical and psychological health of older men. Finally, it delves into age-related changes that increase the risk of constipation, and discusses nursing strategies for assessment, prevention, and management of this common issue, as well as insights gained from the Safe Environments game regarding risk assessment for older adults. The assignment draws on several academic references to support its arguments and provide evidence-based recommendations.

NUR104 Assessment Task 2: Workbook 40%
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1. The majority of older Australian’s continue to live in their own homes, with or without
support. Discuss 2 advantages and 2 challenges of older people remaining in their own
home. (200 words)
/5 marks
2 advantages of older people living in their own home:-
 Elderly people can remain under the care of their families and remain close to
them. Home care promotes recovery as hospital stays of aged care facilities can be
traumatizing. Being in a familiar environment allows the elderly person for
rehabilitating within the comfort zone (Steptoe et al. 2013). A home care honors
the elderly people with love and dignity and keep them away from depression and
anxiety.
 Home care can be cost effective and the saves a family from the unnecessary cost
of the aged care facilities. As per the recent data the average annual cost in
Australia is $85,775 for a private care facility whereas for a home it is about
$37,440 per year (Steptoe et al. 2013).
2 challenges of older people staying in their own home:-
 Elderly people who are frail and cannot cope up with the normal chores of life may
face challenges as they have to be in in constant surveillance of the informal
caregivers, which can increase the physical and mental burden of the caregiver
taking care of the patient. In a family where all the members are working may
really find it difficult to look after the elderly people all the time, in such a case
elderly people may suffer from falls, lack of autonomy and helplessness (Jamieson
& Simpson 2013).
 Home care facilities might not contain all the medical amenities that is required
for handling the geriatric patients, although various smart home technologies are
now available to smoothen the life of the elderly (Morris et al. 2013). Hence

during an emergency condition that patients have rush to the nearby clinical
settings and sometimes might not get enough time to get access to the health
care.
References
Steptoe, A., Shankar, A., Demakakos, P. & Wardle, J., 2013. Social isolation, loneliness,
and all-cause mortality in older men and women. Proceedings of the National Academy of
Sciences, 110(15), pp.5797-5801. https://doi.org/10.1073/pnas.1219686110
Jamieson, L. & Simpson, R., 2013. Living alone: Globalization, identity and belonging.
Springer. https://link.springer.com/book/10.1057%2F9781137318527
Morris, M.E., Adair, B., Miller, K., Ozanne, E., Hansen, R., Pearce, A.J., Santamaria, N.,
Viega, L., Long, M. & Said, C.M., 2013. Smart-home technologies to assist older people to
live well at home. Journal of aging science, 1(1), pp.1-9.
http://dx.doi.org/10.4172/jasc.1000101
2. The My Aged Care website https://www.myagedcare.gov.au/ is a central repository for
information about aged care services in Australia. Discuss how an older person can find
out about services available through My Aged Care. (200 words)
/5 marks
My aged care services website in the initial step to the access to any health care services.
The my aged care website has an open 24x7, landline number that provides all the
information about the types of aged care services available, the eligibility criteria for the
services, the costs that have to be paid for attaining the membership and provisions for
advocacy services. The “my aged care” website is also user friendly that had segregated
specific tabs for the service providers and the health professionals (Australian
government. 2018).
There are also provisions for the emergency care services where the clients can directly
talk to the health professionals about the changes in the health and other medical

matters. The website also contained information about the private services in case the
patient is not eligible for the government funded service or the service is not available in
the access (Duckett & Willcox 2015). The Money Smart website of the Australian
Securities and Investments Commission, would help the elderly people with tools and tips
to manage the invested money. There are some easily accessible links given in the
website that can bring loads of useful information about aged care to the clients.
References
Australian government., 2018. My aged care. This is the place to start. Access date:
12.9.2018. Retrieved from: https://www.myagedcare.gov.au/
Fischer, S.H., David, D., Crotty, B.H., Dierks, M. & Safran, C., 2014. Acceptance and use of
health information technology by community-dwelling elders. International journal of
medical informatics, 83(9), pp.624-635. https://doi.org/10.1016/j.ijmedinf.2014.06.005
Duckett, S. & Willcox, S., 2015. The Australian health care system (No. Ed. 5). Oxford
University Press. Retrieved from:
https://www.cabdirect.org/cabdirect/abstract/20173279780
3. Identify one organization applicable to the older person and discuss how it informs the
support and protection of older people in Australia. (200 words)
/5 marks
Council on the Ageing (ACT) is an organization that that is working for the protection and
the promotion of the well-being, interests of all the older people in the council on ageing.
ACT provides a wide number or services for the seniors of the Australia. There is a senior
Information line hat is available 24x7 that can provide any information about the senior
cards and the discounts (ACT. 2018). ACT helps out the elderly people by doing monthly
social activities, provide attractive aged care and retirement options. They also have
provisions for home support or the house hold assistance, assistance with transport,
community and government services. The organization also provide housing options
advisory services, Advice on the home modifications for the seniors, helps in assessing
proper aged care and transition care facilities (King, Wei & Howe 2013).
The organization also liaise the elderly people to get access to the Australian government
subsidies, that subsidizes the aged care homes in case the patients needed a higher level
of care. They are also a part of the Commonwealth Home support program that provides

support to the elderly people staying at home.
References
ACT., 2018.COTA, For older Australians, Australian Capital Territory., 2018. Access date:
13.9.2018. .Retrieved from: http://www.cotaact.org.au/services/
ACT., 2018.COTA, Australian Board .Access date: 13.9.2018. .Retrieved
from:https://www.cota.org.au/about/governance/cota-australia-board/
King, D., Wei, Z. & Howe, A., 2013. Work satisfaction and intention to leave among direct
care workers in community and residential aged care in Australia. Journal of aging &
social policy, 25(4), pp.301-319. DOI: https://doi.org/10.1080/08959420.2013.816166
4. View video 1.1, where Ray talks about attending the men’s shed. How would attending
a meaningful leisure activity, such as the men’s shed, enhance the physical and
psychological health of older men? (200 words)
/5 marks
Leisure time physical activities by the elderly people results in wellbeing like optimism,
psychological wellbeing, satisfaction in life and positive effect among the older adults with
loneliness (Franco et al. 2014). Positive emotions in the older adults have been found to
be useful in managing depression in the older adults. Meaningful leisure activities helps in
the 'remedying the bad' that is help out the elderly people to cope up with the stressful
situations and traumatic experiences (Kim et al. 2017). It focuses on enhancing the good
by the promotion of positive emotions, spirituality, identities, strength and resilience,
connection and harmony.
Men's shed in Australia provides opportunities to the elderly male to carry out
constructive activities like manufacturing furniture, crafts, mementos and other artefacts.
The organization moreover provide scopes of socialization for the older men, where they
get the opportunity to explore their life once again and spend quality time with the
similar aged people. An organization like this, not only helps to keep these group of
people engaged but also makes them financially independent. The incidental exercises
that these older people perform while carrying out the tasks help them to remain
physically fit (Ryu and Heo 2018). These types of innovative approaches bestows sense of

connectedness among the elderly.
References
Kim, J., Lee, S., Chun, S., Han, A. & Heo, J., 2017. The effects of leisure-time physical
activity for optimism, life satisfaction, psychological well-being, and positive affect among
older adults with loneliness. Annals of Leisure Research, 20(4), pp.406-415.
https://doi.org/10.1080/11745398.2016.1238308
Ryu, J. & Heo, J., 2018. Relationships between leisure activity types and well-being in
older adults. Leisure Studies, 37(3), pp.331-342.
https://doi.org/10.1080/02614367.2017.1370007
Franco, M.R., Tong, A., Howard, K., Sherrington, C., Ferreira, P.H., Pinto, R.Z. &Ferreira,
M.L., 2015. Older people's perspectives on participation in physical activity: a systematic
review and thematic synthesis of qualitative literature. Br J Sports Med, pp.bjsports-2014.
http://dx.doi.org/10.1136/bjsports-2014-094015
5. What age-related changes contribute to increased risk of constipation? What strategies
can the nurse use to assess, prevent and manage constipation? (200 words)
/5 marks
The prevalence of constipation increases with age and generally differs with the settings.
Certain anatomical changes occur in the gastrointestinal tract that ultimately contribute
to a delayed transit time and a decrease in the water content of the stool. Some of the
other change associated to ageing, that can be held responsible for constipation are
intestinal wall atrophy, reduced supply of blood and some intrinsic neuronal changes
(Schuster, Kosar & Kamrul 2015). Some of the other factors like the reduction in the colon
peristalsis, chronic diseases and polypharmacy also increases the chance of constipation
in the older adults.
Nursing strategies to reduce constipation in elderly people
Assessment of constipation in the older adults includes bowel frequency, the longest time

the bowel has been unopened, the consistency of the stool. The elderly patient can be
asked about experiences like passing blood, straining and the urge to defecate and
bloating.
Constipation in older adults can be prevented by the managing the food and drinks. High
fibrous food can be recommended (De Giorgio et al. 2013). Elderly patients are easily de
hydrated. Therefore hydration should be maintained. Management of the constipation in
the older adults include intake of dietary fibers, optimum intake of the fluid between
1500-2000 ml per day (Bishara & Taylor 2014).
Nurses can help the clients to use proper positioning like squat position while the
defecation process. Clients should also be encouraged to perform physical activities like
walking, pelvic tilt and single leg lifts to promote better bowel movement.
References
Schuster, B. G., Kosar, L., & Kamrul, R. (2015). Constipation in older adults: Stepwise
approach to keep things moving. Canadian Family Physician, 61(2), 152–158.
http://www.cfp.ca/content/61/2/152.short
Bishara, D. & Taylor, D., 2014. Adverse effects of clozapine in older patients:
epidemiology, prevention and management. Drugs & aging, 31(1), pp.11-20.
https://doi.org/10.1007/s40266-013-0144-2
De Giorgio, R., Ruggeri, E., Stanghellini, V., Eusebi, L.H., Bazzoli, F.& Chiarioni, G., 2015.
Chronic constipation in the elderly: a primer for the gastroenterologist. BMC
gastroenterology, 15(1), p.130. https://doi.org/10.1186/s12876-015-0366-3
6. The Safe Environments game was used in the week 6 learning materials. What did you
learn about assessing for risks and hazards by interacting with this game? (200 words)
/5 marks
Response
It is necessary to recognize the risks of the older population. Some of the risk factors
associated with the older people are falls and other comorbid conditions. Older people

are subjected to environmental hazards at homes, which may cause accidental injury in
the older people.
Environmental hazards in the elderly people can be caused due to uneven grounds,
cognitive deficits, balance deficits, medications, footwear or some acute illness (Phelan et
al. 2015).
van Schooten et al. (2015) have identified five steps of risk assessment- Identification of
the hazards, deciding the target population who might be harmed, evaluation of the risks
and the decisions on the precautions, recording the findings and implementation,
reviewing of the assessment and updating of the assessment if necessary. A thorough risk
assessment can help in the reduction of the potential injuries and help to make the
everyday task much easier. Safety and convenience can be improved by removing clutter
to extensive modification of the home environment. A helpful safety checklist can be
useful to avoid any risks. Furthermore, the elderly should also go periodically through
each of the rooms for checking whether any safety improvement can be done (Ambrose,
Paul & Hausdorff 2013).
References
Phelan, E. A., Mahoney, J. E., Voit, J. C., & Stevens, J. A. 2015. Assessment and
Management of Fall Risk in Primary Care Settings. The Medical Clinics of North America,
99(2), 281–293. https://doi.org/10.1016/j.mcna.2014.11.004
Ambrose, A.F., Paul, G. & Hausdorff, J.M., 2013. Risk factors for falls among older adults: a
review of the literature. Maturitas, 75(1), pp.51-61. https://doi.org/10.1007/s40266-013-
0144-2
van Schooten, K.S., Pijnappels, M., Rispens, S.M., Elders, P.J., Lips, P. & van Dieën, J.H.,
2015. Ambulatory fall-risk assessment: amount and quality of daily-life gait predict falls in
older adults. Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences,
70(5), pp.608-615. https://doi.org/10.1093/gerona/glu225

7. Page 48 of your textbook lists several challenges confronting aged care in Australia.
Discuss the difficulty attracting graduate health professionals in aged care in Australia,
using current literature to support your response. Identify strategies that could be
enacted to overcome this challenge. (200 words)
/5 marks
Difficulty attracting graduate health professionals in aged care in Australia
Some of the main reasons for the shortage of staffs in the aged care sector is the wage
disparity that has led to the staffing crisis. Furthermore, the health care workers in the
aged care sector suffer from more burnout as aged people are subjected to acute health
care condition, chronic diseases and generally needs more attentiveness and care
compared to that of the other age groups (Dawson et al. 2014). Elders are subjected to
more chronic conditions like cardiovascular diseases, cancers and chronic respiratory
diseases, vision and dental problems (Mugisha et al. 2016). The freshly graduate nurses
might find it difficult to work in the aged care facilities situated in rural areas.
Strategies
 Supportive personal care workers are one of the important factors in the clinical
placement that would determine whether the students will be returning to the
aged care sector after the completion of the graduation.
 A good placement program is necessary to attract the graduate nurses in the aged
care sector led by the senior registered nurses as a mentor leader. Separate
feedbacks should be held by both the mentor leaders and the students for
discussing the placement areas (Algoso et al. 2016).
 Finally it is a positive teaching and a learning environment that can encourage the
freshly graduate nurses to take up their career in the aged care sector.
 Students taking up their career in aged care should be provided with better

remuneration for reducing the turnover of the employees.
References
Mugisha, J. O., Schatz, E. J., Randell, M., Kuteesa, M., Kowal, P., Negin, J., & Seeley, J.
2016. Chronic disease, risk factors and disability in adults aged 50 and above living with
and without HIV: findings from the Wellbeing of Older People Study in Uganda. Global
Health Action, 9, 10.3402/gha.v9.31098. https://doi.org/10.3402/gha.v9.31098
Bernoth, M. & Winkler, D., 2016. Healthy ageing and aged care. OUPANZ.
https://books.google.co.in/books?
id=hzCoDAEACAAJ&dq=Healthy+ageing+and+aged+care&hl=en&sa=X&ved=0ahUKEwj89I
OmxLfdAhVIwbwKHbvLBnwQ6AEIJjAA
Dawson, A.J., Stasa, H., Roche, M.A., Homer, C.S. & Duffield, C., 2014. Nursing churn and
turnover in Australian hospitals: nurses perceptions and suggestions for supportive
strategies. BMC nursing, 13(1), p.11. https://doi.org/10.1186/1472-6955-13-11
Algoso, M., Peters, K., Ramjan, L. & East, L., 2016. Exploring undergraduate nursing
students' perceptions of working in aged care settings: A review of the literature. Nurse
education today, 36, pp.275-280. https://doi.org/10.1016/j.nedt.2015.08.001
Reference List
ACT., 2018.COTA, For older Australians, Australian Capital Territory., 2018. Access date:
13.9.2018. .Retrieved from:http://www.cotaact.org.au/services/
ACT., 2018.COTA, Australian Board .Access date: 13.9.2018. .Retrieved
from:https://www.cota.org.au/about/governance/cota-australia-board/
Algoso, M., Peters, K., Ramjan, L. & East, L., 2016. Exploring undergraduate nursing
students' perceptions of working in aged care settings: A review of the literature. Nurse
education today, 36, pp.275-280. https://doi.org/10.1016/j.nedt.2015.08.001

Ambrose, A.F., Paul, G. & Hausdorff, J.M., 2013. Risk factors for falls among older adults: a
review of the literature. Maturitas, 75(1), pp.51-61. https://doi.org/10.1007/s40266-013-
0144-2
Australian government. 2018. My aged care. This is the place to start. Access date:
12.9.2018. Retrieved from: https://www.myagedcare.gov.au/
Bernoth, M. & Winkler, D., 2016. Healthy ageing and aged care. OUPANZ.
https://books.google.co.in/books?
id=hzCoDAEACAAJ&dq=Healthy+ageing+and+aged+care&hl=en&sa=X&ved=0ahUKEwj89I
OmxLfdAhVIwbwKHbvLBnwQ6AEIJjAA
Bishara, D. & Taylor, D., 2014. Adverse effects of clozapine in older patients:
epidemiology, prevention and management. Drugs & aging, 31(1), 11-20.
https://doi.org/10.1007/s40266-013-0144-2
Dawson, A.J., Stasa, H., Roche, M.A., Homer, C.S. & Duffield, C., 2014. Nursing churn and
turnover in Australian hospitals: nurses perceptions and suggestions for supportive
strategies. BMC nursing, 13(1), p.11. https://doi.org/10.1186/1472-6955-13-11
Duckett, S. & Willcox, S., 2015. The Australian health care system (No. Ed. 5). Oxford
University Press. Retrieved from:
https://www.cabdirect.org/cabdirect/abstract/20173279780
Franco, M.R., Tong, A., Howard, K., Sherrington, C., Ferreira, P.H., Pinto, R.Z. &Ferreira,
M.L., 2015. Older people's perspectives on participation in physical activity: a systematic
review and thematic synthesis of qualitative literature. Br J Sports Med, pp.bjsports-2014.
Jamieson, L. & Simpson, R., 2013. Living alone: Globalization, identity and belonging.
Springer. http://dx.doi.org/10.1136/bjsports-2014-094015
Fischer, S.H., David, D., Crotty, B.H., Dierks, M. & Safran, C., 2014. Acceptance and use of
health information technology by community-dwelling elders. International journal of

medical informatics, 83(9), pp.624-635. https://doi.org/10.1016/j.ijmedinf.2014.06.005
Kim, J., Lee, S., Chun, S., Han, A. & Heo, J., 2017. The effects of leisure-time physical
activity for optimism, life satisfaction, psychological well-being, and positive affect among
older adults with loneliness. Annals of Leisure Research, 20(4), pp.406-415.
https://doi.org/10.1080/11745398.2016.1238308
King, D., Wei, Z. & Howe, A., 2013. Work satisfaction and intention to leave among direct
care workers in community and residential aged care in Australia. Journal of aging &
social policy, 25(4), pp.301-319. DOI: https://doi.org/10.1080/08959420.2013.816166
Morris, M.E., Adair, B., Miller, K., Ozanne, E., Hansen, R., Pearce, A.J., Santamaria, N.,
Viega, L., Long, M. & Said, C.M., 2013. Smart-home technologies to assist older people to
live well at home. Journal of aging science, 1(1), pp.1-9.
http://dx.doi.org/10.4172/jasc.1000101
Mugisha, J. O., Schatz, E. J., Randell, M., Kuteesa, M., Kowal, P., Negin, J., & Seeley, J.
2016. Chronic disease, risk factors and disability in adults aged 50 and above living with
and without HIV: findings from the Wellbeing of Older People Study in Uganda. Global
Health Action, 9, 10.3402/gha.v9.31098. https://doi.org/10.3402/gha.v9.31098
Phelan, E. A., Mahoney, J. E., Voit, J. C., & Stevens, J. A. 2015. Assessment and
Management of Fall Risk in Primary Care Settings. The Medical Clinics of North America,
99(2), 281–293. https://doi.org/10.1016/j.mcna.2014.11.004
Ryu, J. & Heo, J., 2018. Relationships between leisure activity types and well-being in
older adults. Leisure Studies, 37(3), pp.331-342.
https://doi.org/10.1080/02614367.2017.1370007
Schuster, B. G., Kosar, L., & Kamrul, R. (2015). Constipation in older adults: Stepwise
approach to keep things moving. Canadian Family Physician, 61(2), 152–158.
http://www.cfp.ca/content/61/2/152.short
Steptoe, A., Shankar, A., Demakakos, P. & Wardle, J., 2013. Social isolation, loneliness,
and all-cause mortality in older men and women. Proceedings of the National Academy of

Sciences, 110(15), pp.5797-5801. https://doi.org/10.1073/pnas.1219686110
van Schooten, K.S., Pijnappels, M., Rispens, S.M., Elders, P.J., Lips, P. & van Dieën, J.H.,
2015. Ambulatory fall-risk assessment: amount and quality of daily-life gait predict falls in
older adults. Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences,
70(5), pp.608-615. https://doi.org/10.1093/gerona/glu225